Complete this Order Form, PRINT IT from your browser and Fax it to (319) 373-0669. Your First Name, Last Name, and Address must be entered as they appear on your credit card statement. Most browsers will allow you to type in the fields below then print the order form.

*First Name  *Last Name  Company  *Address  *City    *State *Zip  Country  *Phone Number  ( ) - *E-Mail Address  VERY IMPORTANT: Please verify that your e-mail address is correct. Where Did You Hear  About Theme-Pak '98

Please enter your credit card information. We currently accept   *Credit Card Number * Expiration Date  (Example: June, 1998 or 6 / 98 enter 0698) *Shipping Options Your order will be processed within in one business day. You will be e-mailed instruction on where and how to download your Theme-Pak order if you have purchased Online Delivery items.